Select the best question for the nurse to ask to help her assess a family's ability to cope?

Choice A reason: Patients with restrictive eating disorders, such as anorexia nervosa, frequently exhibit dry, flaky skin (xerosis) due to severe malnutrition and dehydration. The body lacks the essential fatty acids and hydration necessary to maintain the skin barrier, and a lowered metabolic rate reduces the production of natural skin oils.

Choice B reason: Malnutrition typically causes hair to become thin, brittle, and prone to falling out (alopecia) rather than coarse. Additionally, many patients develop lanugo, which is a fine, downy hair on the face and body, as a physiological response to preserve body heat in the absence of subcutaneous fat.

Choice C reason: Fever is an indication of infection or inflammation. In contrast, patients with severe eating disorders often present with hypothermia (low body temperature) because the body lacks the caloric energy and adipose tissue needed to generate and retain heat, leading to cold intolerance and a low basal metabolic rate.

Choice D reason: Hypertension (high blood pressure) is not expected in this population. Malnutrition and fluid restriction generally lead to hypotension (low blood pressure) and bradycardia (slow heart rate) as the heart muscle weakens and the body enters a state of energy conservation to protect vital organs during prolonged starvation.

Choice A reason: Narcissistic personality disorder is characterized by grandiosity and a lack of empathy. While these traits make social interaction difficult, they rarely necessitate acute inpatient psychiatric hospitalization unless the individual experiences a co-occurring major depressive episode or a significant crisis leading to self-harm or psychosis.

Choice B reason: Individuals with dependent personality disorder exhibit an excessive need to be taken care of and are submissive. While they may experience high anxiety or depression when a relationship ends, they are generally managed in outpatient settings through therapy rather than in an acute psychiatric stabilization unit.

Choice C reason: Borderline personality disorder involves significant emotional dysregulation and high levels of impulsivity. These patients frequently engage in non-suicidal self-injury or suicidal gestures during crises. Due to the high risk of self-harm and the instability of their moods, they are the most frequent personality disorder admissions.

Choice D reason: While individuals with antisocial or paranoid traits may be dangerous, the commission of crimes usually leads to legal incarceration rather than psychiatric admission. Psychiatric units are for clinical stabilization of mental illness, whereas criminal behavior in the absence of acute psychosis is handled by the justice system.